PS01.019: BARIUM FLUOROSCOPY AS A GOOD DIAGNOSTIC MODALITY FOR THE PATIENTS WITH LATE DIAGNOSIS OF ESOPHAGEAL ACHALASIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 55-55
Author(s):  
Toru Nakano ◽  
Ken Koseki ◽  
Chikashi Shibata ◽  
Takashi Kamei ◽  
Tadashi Ishii
Keyword(s):  
Eating Disorders ◽  
Conflicts Of Interest ◽  
Delayed Diagnosis ◽  
Unknown Origin ◽  
Esophageal Achalasia ◽  
University Hospital ◽  
Barium Study ◽  
Diagnostic Modality ◽  
Group A ◽  
Group B

Abstract Background Achalasia is a relatively rare disorder and the diagnosis would be delayed or mistaken as eating disorders like as anorexia nervosa. This study aimed to assess the diagnostic modalities to find the potential achalasia with delayed diagnosis. Methods Thirty-eight patients of achalasia presented to Tohoku University Hospital during 2006 to 2015 were retrospectively analyzed based on the medical records. Twenty-three patients that took less than 6 months to diagnosis (group A); 15 patients that took more than 6 months (group B) were evaluated in the duration for diagnosis, modalities and their clinical findings. Results No patients of group B and 16 of 21 patients of group A underwent barium study in the first 6 months after visiting to their physician (P = 0.0001). During the subsequent clinical coarse after 6 months from first visit to physician, 13 cases and 8 cases of group B were diagnosed by barium study and by endoscopic examination, respectively. Conclusion No obstructive finding of gastrointestinal endoscopy is insufficient to deny the possibility of achalasia. It is useful for patients with eating disorders due to unknown origin should be considered to perform the barium study to make potential achalasia apparent. Disclosure All authors have declared no conflicts of interest.

Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Shiraz Shaikh ◽  
Ambreen Munir ◽  
Shahnawaz Abro ◽  
Shahida Khatoon ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
General Surgery ◽  
Stable Condition ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
University Hospital ◽  
P Value ◽  
Modified Radical Mastectomy ◽  
Group A ◽  
Group B

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna
Keyword(s):  
Colorectal Cancer ◽  
Comparative Study ◽  
Disease Free Survival ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinicopathologic Features ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

scholarly journals Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11534
Author(s):  
Stefano Sartini ◽  
Laura Massobrio ◽  
Ombretta Cutuli ◽  
Paola Campodonico ◽  
Cristina Bernini ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Adverse Outcome ◽  
University Hospital ◽  
Rt Pcr ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

Energy-Based Devices Affect the Aesthetic Outcome of Cervical Thyroidectomy and Parathyroidectomy. A Retrospective Study

2021 ◽  
Vol 39 ◽  
Author(s):  
Antonella Pino ◽  
◽  
Lorenzo Gasco ◽  
Daqi Zhang ◽  
Paolo Carcoforo ◽  
...  
Keyword(s):  
Body Dysmorphic Disorder ◽  
The Body ◽  
University Hospital ◽  
Aesthetic Outcome ◽  
Aesthetic Result ◽  
Scar Assessment ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
The Impact

Introduction: Thyroid and parathyroid diseases are very common. Most of these cases are in women and may be amenable to surgery. The patient’s perception that these are not life-threatening diseases leads them to expect an excellent aesthetic result, since the surgical incision area is clearly visible. Objective: To evaluate different scarring outcomes using three different energy-based devices (Harmonic Focus®, Johnson & Johnson, New Brunswick, NJ; Thunderbeat Open Fine Jaw®, Olympus Medical, Tokyo, Japan; LigaSure Small Jaw®, Medtronic, Dublin, Ireland) and to determine the impact of post-thyroidectomy/parathyroidectomy scars on the patient’s quality of life. Methods: One hundred female patients who underwent thyroidectomy or parathyroidectomy between September 2017 and September 2019 at the Endocrine and Minimally Invasive Surgery Department of Messina University Hospital were recruited. A retrospective analysis assessed the thickness of the cervical scar via ultrasound imaging, and the patient’s degree of satisfaction through the Patient and Observer Scar Assessment Scale (POSAS) and the Body Dysmorphic Disorder Questionnaire (BDDQ). Results: The patients were divided into three groups according to the energy-device used: group A (LigaSure SJ (n=38), group B (Harmonic F, n=32) and group C (Thunderbeat OFJ, n=30). The three groups were homogeneous with respect to number of patients, age and surgical procedures. The best aesthetic result, which correlated with the lowest scar thickness, was observed in group A; these patients were more satisfied than those in the other two groups. Moreover, correlations between scar thickness and quantitative variables (such as age or BMI) were not found in any of the groups. Conclusions: Based on the data collected and our experience, the LigaSure Small Jaw® (Medtronic) seems to offer the best aesthetic outcome in patients who undergo transverse cervicotomy for thyroid and parathyroid diseases. However, further prospective studies involving a greater number of cases are needed.

A Foxtail-Shaped Vermilion Flap to Reconstruct the Medial Tubercle in Asymmetric Bilateral Cleft Lip With Contralateral Lesser Form Defect

2019 ◽  
Vol 56 (8) ◽  
pp. 1052-1057
Author(s):  
Yuta Nakajima ◽  
Shunsuke Yuzuriha ◽  
Fumio Nagai ◽  
Kenya Fujita ◽  
Masahiko Noguchi
Keyword(s):  
Cleft Lip ◽  
Primary Repair ◽  
Tertiary Care ◽  
Senior Author ◽  
The Body ◽  
University Hospital ◽  
Bilateral Cleft Lip ◽  
Group A ◽  
Cleft Lip Repair ◽  
Group B

Objective: There have been few reports addressing asymmetric bilateral cleft lip repair with contralateral lesser form defects. Two studies have described the thin medial tubercle as the most common remaining labial deformity. In this study, we aimed to evaluate the use of a foxtail-shaped vermilion flap to reconstruct the median tubercle in primary repair. Design: A blinded retrospective study of photography and chart review. Setting: Shinshu University Hospital, tertiary care. Private practice. Patients: Forty-nine patients with asymmetric bilateral cleft lip with lesser form defects treated using a primary “unilateral” repair by the senior author (S.Y.) between 2007 and 2017. Interventions: The foxtail-shaped vermilion flap was applied at the time of the primary nasolabial repair. This flap is similar to Noordhoff laterally based triangular vermilion flap but with modifications to the shape and length. The body of the flap is wider than the pedicle to add tissue to the center of the vermilion, and the length is sufficiently elongated to reach the lesser side. Main Outcome Measure: Lip shape was graded on a 4-point scale when patients were 1 year old. Results: Twenty-two patients were treated with the foxtail-shaped vermilion flap (group A) and 27 patients with Noordhoff triangular vermilion flap (group B). Group A had a better lip shape than group B ( P = .006). Conclusions: The foxtail-shaped vermilion flap is useful to reconstruct the median tubercle in asymmetric bilateral cleft lip repair with contralateral lesser form defects.

PS01.063: THE EFFECT OF DISEASE DURATION ON SURGICAL OUTCOMES FOR PATIENTS WITH EROSIVE GERD TREATED BY LAPAROSCOPIC SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 67-67
Author(s):  
Kazuto Tsuboi ◽  
Nobuo Omura ◽  
Fumiaki Yano ◽  
Masato Hoshino ◽  
Se-Ryung Yamamoto ◽  
...  
Keyword(s):  
Los Angeles ◽  
Surgical Outcomes ◽  
Disease Duration ◽  
Conflicts Of Interest ◽  
Operation Time ◽  
Acid Reflux ◽  
Los Angeles Classification ◽  
Patients Satisfaction ◽  
Group A ◽  
Group B

Abstract Background Erosive gastro-esophageal reflux disease (e-GERD) is associated with various symptoms caused by reflux of acid and gastric contents from the stomach to the esophagus. In general, it seems that as the duration of the disease is longer, surgical outcomes are inferior because of disease progression. The aim of this study is to evaluate the relationship between the disease duration and surgical outcomes of laparoscopic fundoplication (LF). Methods Two hundred and fifty-one (mean age was 53.4 years, male in 166) patients with e-GERD who underwent LF as an initial operation at our institution were extracted from the database. E-GERD was defined as equal to or more than grade A esophagitis by Los Angeles classification. These patients were divided into three groups by the length of disease duration: less than two years in Group A (n = 104), two to 5 years in Group B (n = 68) and equal to or more than 5 years in Group C (n = 79). We analyzed patients’ background, pre-operative symptoms, surgical outcomes, patients’ satisfaction and post-operative course. Before surgery, a standardized questionnaire was used to assess the degree of frequency and severity of symptoms (heartburn, regurgitation, dysphagia, vomiting and chest pain). Moreover, satisfaction with the operation was evaluated using the standardized questionnaire. Results Age and degree of acid reflux by pH-metry were significantly different among the three groups (P = 0.0054 and 0.0345, respectively). As to the pre-operative symptom score, the severity score of heartburn and the frequency score of regurgitation were significantly lower in Group A (P = 0.0225 and 0.031, respectively). Although operation time was significantly difference among the three groups (P = 0.0423), there were no differences in intraoperative blood loss, occurrence of peri-operative complications, post-operative course and patients’ satisfaction. Conclusion Although the patients who suffered equal to or over two years had more severe heartburn and regurgitation because of prolonged acid reflux, the duration of the disease does not seem to affect the surgical outcomes. Disclosure All authors have declared no conflicts of interest.

PS01.204: ANASTOMOTIC LEAKS AFTER IVOR-LEWIS ESOPHAGECTOMY: INDOCYANINE GREEN NEAR-INFRERED ANGIOGRAPHY FOR GASTRIC CONDUIT BLOOD SUPPLY EVALUATION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 107-107
Author(s):  
Paolo Parise ◽  
Andrea Cossu ◽  
Leonardo Garutti ◽  
Francesco Puccetti ◽  
Ugo Elmore ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Blood Supply ◽  
Near Infrared ◽  
Conflicts Of Interest ◽  
Gastric Conduit ◽  
Smoking History ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Group A ◽  
Group B

Abstract Background Indocyanine Green—Angiography (ICG-A) has been recently introduced for visceral perfusion evaluation. Aim of this study is to assess whether the intraoperative use of ICG-A can improve the evaluation of blood supply of the gastric conduit in Ivor-Lewis esophagectomy for cancer. Methods This is an interim analysis of a prospective interventional study ongoing at our Institution, on 160 Ivor-Lewis esophagectomy patients. After an intravenous bolus of ICG during the abdominal and thoracic stage, the gastric conduit perfusion was evaluated by means of a near infrared ICG-A and graded as ‘well’, ‘hypo-perfused’ or ‘ischemic’. If present, the ischemic or hypo-perfused area was resected. Demographic and clinical parameters and others, such as conduit perfusion speed, intra or post-operative hypotensive episodes have been analyzed. Results Currently 26 patients have been enrolled. An anastomotic leak of any grade was identified in 7 patients. Patients were divided in Group A (7 patients) who developed a leak and Group B (19 patients) who do not. No statistically significant differences were evidenced on demographic and preoperative clinical features, except for higher cigarette smoking history incidence in Group A. Those who developed a leak had an ‘hypo-perfused’ conduit at ICG-A in 71.4% and those who do not in only 15.8% (p 0.014). Median time from ICG injection to appearance of fluorescence at the basis of the gastric conduit was significantly longer in Group A than in Group B, 36 sec. (32–43.5) vs 28 sec. (20–39.8) (p 0.04) but median gastric conduit perfusion speed was similar. Patients in Group B had a higher median width of the conduit than Group A, 5cm (5.0–6.0) vs 4 (4.0–5.0) (p 0.032). Post-operative prolonged hypotensive episodes were seen more frequently in Group A than Group B (p 0.028). No differences were evidenced in terms of fluids infusions, blood loss, conduit length or intraoperative hypotensive episodes. Conclusion Preliminary results seem to show the usefulness of ICG-A in identifying patients at risk of leakage. Nevertheless no reduction of leakage incidence was induced by surgical strategy modification, probably because post-operative events may affect clinical course too. Definitive data have to be awaited. Disclosure All authors have declared no conflicts of interest.

Carbamazepine Phakmacokinetics in Obese and Lean Subjects

1995 ◽  
Vol 29 (9) ◽  
pp. 843-847 ◽  
Author(s):  
Yoseph Caraco ◽  
Ester Zylber-Katz ◽  
Elliot M Berry ◽  
Micha Levy
Keyword(s):  
Body Weight ◽  
Single Dose ◽  
Ideal Body Weight ◽  
Obese Group ◽  
University Hospital ◽  
Pharmacokinetic Parameters ◽  
Group A ◽  
Obese Subjects ◽  
Group B ◽  
Lean Group

Objective: To compare carbamazepine pharmacokinetic parameters between obese and lean subjects following the administration of a single 200-mg tablet. Design: Single-dose intervention, open study. Setting: Teaching university hospital. Subjects: Eighteen obese (group A) otherwise healthy subjects, referred to the metabolic outpatient clinic, and 13 healthy lean (group B) volunteers. Inclusion criterion for the obese subjects was a body mass index (BMI = weight/height2) of more than 30 kg/m2. In the obese group, mean ± SD total body weight (TBW), BMI, and percent of ideal body weight (IBW) were 111.4 ± 19.9 kg, 38.8 ± 6.0 kg/m2, and 182.7% ± 30.7%, respectively. These values were significantly greater than the respective values of 63.2 ± 8.3 kg, 22.4 ± 1.6 kg/m2, and 105.8% ± 5.8% obtained in the lean group (p < 0.001). Intervention: Single-dose oral administration of carbamazepine 200-mg tablet (Teril, Taro, Israel). Outcomes: Carbamazepine elimination half-life (t1/2), apparent volume of distribution (Varea/F), and its oral clearance (Clpo/F) were derived from the drug concentration-time curves. Results: Carbamazepine Varea/F and t1/2 were significantly greater in group A than in group B (98.4 ± 26.9 vs. 60.7 ± 8.5 L, respectively, p < 0.001; and 59.4 ± 14.7 vs. 31.0 ± 5.0 h, respectively, p < 0.001), but its Clpo/F was reduced only slightly in obese as compared with lean subjects (19.8 ± 5.2 vs. 23.0 ± 4.6 mL/min, respectively, p = 0.07). Correction for IBW yielded similar results for Varea/F and t1/2, but Clpo/F per kg of IBW was significantly smaller in the obese than in the lean subjects (0.32 ± 0.07 vs. 0.39 ± 0.06 mL/min/kg of IBW, respectively, p < 0.02). Linear correlations were observed between Varea/F and TBW for both group A (r = 0.92, p < 0.001) and group B (r = 0.77, p < 0.002). Conclusions: In comparison with lean subjects, carbamazepine Varea/F is significantly greater in obese subjects and its t1/2 is markedly prolonged. The minor nonsignificant effect of obesity on carbamazepine Clpo/F suggests that in obese subjects the carbamazepine daily dose should be based on IBW, not on TBW.

scholarly journals Readjustment of abdominal computed tomography protocols in a university hospital: impact on radiation dose

2015 ◽  
Vol 48 (5) ◽  
pp. 292-297 ◽  
Author(s):  
Ricardo Francisco Tavares Romano ◽  
Priscila Silveira Salvadori ◽  
Lucas Rios Torres ◽  
Elisa Almeida Sathler Bretas ◽  
Daniel Bekhor ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Clinical Suspicion ◽  
University Hospital ◽  
Abdominal Ct ◽  
Abdominal Computed Tomography ◽  
Computed Tomography Scans ◽  
Group A ◽  
Group B ◽  
Tomography Scan

AbstractObjective:To assess the reduction of estimated radiation dose in abdominal computed tomography following the implementation of new scan protocols on the basis of clinical suspicion and of adjusted images acquisition parameters.Materials and Methods:Retrospective and prospective review of reports on radiation dose from abdominal CT scans performed three months before (group A – 551 studies) and three months after (group B – 788 studies) implementation of new scan protocols proposed as a function of clinical indications. Also, the images acquisition parameters were adjusted to reduce the radiation dose at each scan phase. The groups were compared for mean number of acquisition phases, mean CTDIvol per phase, mean DLP per phase, and mean DLP per scan.Results:A significant reduction was observed for group B as regards all the analyzed aspects, as follows: 33.9%, 25.0%, 27.0% and 52.5%, respectively for number of acquisition phases, CTDIvol per phase, DLP per phase and DLP per scan (p < 0.001).Conclusion:The rational use of abdominal computed tomography scan phases based on the clinical suspicion in conjunction with the adjusted images acquisition parameters allows for a 50% reduction in the radiation dose from abdominal computed tomography scans.

Increase of the Bioavailabllity of Intraperitoneal Erythropoietin in Children on Peritoneal Dialysis by Administration in Small Dialysis Bags

1997 ◽  
Vol 17 (5) ◽  
pp. 467-470 ◽  
Author(s):  
Roel E. Reddingius ◽  
Alberdina W. De Boer ◽  
Cornelis H. Schröder ◽  
Johannes L. Willems ◽  
Leo A.H. Monnens
Keyword(s):  
Peritoneal Dialysis ◽  
Transferrin Saturation ◽  
Intraperitoneal Administration ◽  
Hemoglobin Level ◽  
Wilcoxon Test ◽  
University Hospital ◽  
Renal Anemia ◽  
Dialysis Fluid ◽  
Group A ◽  
Group B

Objective To establish the effectivity of administration of erythropoietin intraperitoneally in a small amount of fluid in children with renal anemia on continuous ambulatory peritoneal dialysis (CAPD). Design Prospective study in which children with renal anemia on CAPD were treated with erythropoietin intraperitoneally, administered in a specially designed bag containing 50 mL NaCl 0.9%. Setting University hospital. Patients The patient population consisted of 9 children treated with CAPD and 1 treated with nightly intermittent peritoneal dialysis. The median age was 7.8 years (range 4.1 -15.2). Four of these children had not been treated with erythropoietin before (group A), and 6 had been treated with erythropoietin administered intraperitoneally in 250 mL of dialysis fluid (group B). Interventions Patients in group A started on a dose of approximately 300 units/kg per week (group A). Patients in group B received their previous dose. Do sage was adjusted to achieve a target hemoglobin level of 6.5 7.0 mmol/L (104 -112 g/L). Serum ferritin levels and transferrin saturation were monitored and iron supplementation was prescribed in the case of iron deficiency. Main outcome measures Weekly erythropoietin dose in relation to hemoglobin level. Results In group A, median hemoglobin level rose from 5.3 mmol/L (85 g/L) to 6.6 mmol/L (106 g/L) after 6 months of therapy, whereas the median erythropoietin dose decreased from 266 to 234 U/kg/week. In group B, hemoglobin levels remained stable and median erythropoietin dose decreased from 262 to 194 U/kg/week. One patient in this group, for unknown reasons, never responded to erythropoietin treatment. He was excluded from further analysis. In the remaining 5 patients the median cumulative erythropoietin dose was 3250 U/kg in the 3-month period prior to the start of the study and 2713 in the 3-month period starting 6 months after the beginning of the study. This difference of 17% was statistically significant using a Wilcoxon test (p < 0.05). Conclusion Intraperitoneal administration of erythropoietin in a small amount of dialysis fluid leads to a decrease in the required dose.

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